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What No One Tells You About a Common Cause of Miscarriage

It’s not just a woman’s body that can play a role in pregnancy loss. Acknowledging that male factors also lead to miscarriage can help reduce the lonely burden many women bare in its aftermath. Despite what we’ve been taught, a man’s role in making a baby does not end after he provides the sperm to meet the egg. The quality of that sperm can determine whether a pregnancy continues, and poor sperm quality is a common cause of miscarriages. Understanding how the often-ignored male partner impacts the success of a pregnancy can actually decrease the odds of having a miscarriage in some cases.

Dr. Paul Turek is a Stanford-trained urologist and leading innovator in male reproductive health. He broke down for me the different male factors that can lead to miscarriage. The first, which has been known for about 50 years, is called “Robertsonian translocations.” It involves chromosomal problems with the sperm. Turek explained that in this case “the imbalanced chromosomal mass in sperm mucks up embryo development soon after fertilization, and things fall apart from there.” If you’ve had miscarriages and your partner has a low sperm count (which you should test if you’ve experienced repeated pregnancy loss), this could be a sign he has this issue. “When it comes to chromosomal issues, a man is what he is and there is little to be done to fix things,” Turek explained. “A successful pregnancy here becomes a game of odds.” You have to keep trying and hope you get balanced sperm.

A more recently defined paternal cause of miscarriages is called DNA fragmentation. “The way this plays out is that after the egg is fertilized, it asks the sperm to unpackage its DNA for inspection,” Turek told me. “When fragmented paternal DNA undresses, it is loaded with double-strand DNA breaks that overwhelm the ability of the egg to repair it and the embryo ceases to develop further.” In other words, the egg performs a sort of “quality control” on the sperm, and if there are issues that can’t be fixed you’ll have a miscarriage.

How common is it for male factors to lead to miscarriages? “Now that we know more about sperm DNA fragmentation and epigenetics, it is estimated to be between 25 to 50 percent of the time of the time,” Turek said. “When it comes to influencing pregnancy outcomes,” he added, “we now know that men aren’t as innocent as they were thought to be.”

How to Address the Male Cause of Miscarriage

In the case of DNA fragmentation, your partner can make changes to increase your odds of a successful pregnancy. “There are many lifestyle issues that affect sperm quality including heat, tobacco, diet, weight, and exercise,” Turek said. In addition, disorders like infections, illnesses with fevers, and varicoceles can also reduce the robustness of sperm DNA. “The bottom line is that men can potentially improve their DNA payload that they deliver to the egg through several simples measures,” Turek explained. These include:

See a male reproductive specialist

If a woman experiences pregnancy loss, she might see a fertility specialist. But don’t ignore the male partner. “A good medical history and a quick physical exam can find many things that could be fixed or improved to lead to healthier pregnancies,” Turek advised.

Consider the male partner’s age

“Since many issues with sperm increase with paternal age, consider starting family building when you’re young,” Turek said, pointing out that men have a type of biological clock, too. While you can’t go back in time, you can consider this in your overall family planning. For example, if you had a miscarriages while trying to have your first child, you might not wait too long to try for a second. Turek said the number at which paternal age goes from “young” to “advanced” has been hotly debated. “Typically, it’s either 40 years or at the latest 50 years old,” he explained, noting that the risks associated with advanced paternal age rise only slowly and linearly between 30 and 60 years of age and then begin to rise rapidly after that.

While pregnancy loss can be an isolating experience, miscarriage is not a failure for women or for men. Understanding the biological causes, rather than giving into societal stereotypes about women who experience miscarriages, can empower women and their partners to tackle the struggle together.

Featured image by Jesse Leake

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